Most days, Brennen Smith wakes up nauseous, and he sometimes spends the first hours of his day vomiting blood. “My symptoms include intense stomach cramping and pain, stomach ulcers, and chronic constipation,” explains the 24 year-old laboratory technician from the state of Washington, USA.
When he was 10 years old, Smith was diagnosed with both Irritable Bowel Disease (IBD) and irritable bowel syndrome (IBS).
IBD is an umbrella term for two inflammatory diseases – Crohn’s, which Smith has, and ulcerative colitis. IBD can range from mild to severe, and is usually treated with medication. In severe cases, patients may have to undergo a colostomy surgery, where the colon is re-routed so that waste can be collected in an ostomy bag worn outside the body.
IBS is an unrelated catch-all diagnosis for a collection of digestive symptoms with unknown causes, including diarrhea, constipation, and abdominal pain.
Smith says that IBD and IBS have profoundly impacted his life. “I’ve had x-rays done on my intestines. I’ve swallowed little cameras so they could see inside me, and I’ve had a colonoscopy. Living with Crohn’s and IBS, for me, means that I have to be very cautious about what I eat. Sometimes the cramping is so bad I have to stay in bed.”
Despite this, Smith holds down a job as a laboratory technician, and he credits cannabis with helping him live a better life.
When he was just 12 years old, Smith began using cannabis tinctures to treat his symptoms.
“They didn’t get me high at all, but within 30 minutes to an hour, my nausea would go away and I would be able to eat. [These days] I eat a very small dose of cannabis distillate first thing in the morning… Cannabis allows me to live a normal life.”
“Without [cannabis] I can’t eat breakfast, I’m constantly in stomach pain, and I cannot pass stool. With it I feel like a normal human being. My body is more regular now and I am not in as much pain. It has afforded me a quality of living that no over-the-counter pharmaceutical could provide.”
Smith’s experience is supported by recent research and ancient history alike. Cannabis has been used to treat gastrointestinal conditions for centuries. More recently, it’s been employed as a treatment for intestinal inflammation, low appetite, vomiting, diabetic gastroparesis, diarrhea and abdominal pain.
When it comes to inflammatory bowel disease, research is particularly promising. A 2011 observational study from Israel found that an astounding 70 per cent of Crohn’s disease patients improved significantly after cannabis treatment. More impressively, in an eight-week trial conducted in 2018, the same team found that an oil containing a 4:1 ratio of CBD to THC produced clinical remission in around 65 per cent of study subjects. Interestingly, however, the researchers did not attribute these beneficial results to cannabis’s anti-inflammatory effects.
“We have previously demonstrated that cannabis can produce measurable improvements in Crohn’s disease symptoms but, to our surprise, we saw no statistically significant improvements in endoscopic scores or in the inflammatory markers we measured in the cannabis oil group compared with the placebo group,” said the study’s lead, Dr. Timna Naftali. “We know that cannabinoids can have profound anti-inflammatory effects but this study indicates that the improvement in symptoms may not be related to these anti-inflammatory properties,” she said, citing the need for further study.
There is less research available on cannabis and IBS, but cannabis may be useful for common symptoms of the disorder. Natural Care nurse practitioner Lynn Haslam says she is optimistic about cannabis for the treatment of digestive disorders.
“Research supports the idea that cannabis can help treat digestive disorders like Crohn’s, ulcerative colitis and IBS,” she explains.
“Most patients are using multiple approaches to manage their symptoms, including diet, medications, stress reduction, etcetera. Cannabis is considered an adjunct treatment used alongside other approaches,” she continues.
Haslam emphasized that although cannabis may treat the symptoms effectively, it doesn’t treat the underlying cause of the disorder.
“For chronic diseases, patients should remember that [cannabis] is not fixing the underlying issue. Like many other medications, it is only treating the symptoms.”
Haslam thinks cannabis can be a better option than some traditional medications, however.
“Many of the medications currently used as first-line treatments for IBS can have unwanted side effects,” she explains. “Cannabis tends to have fewer [of these].”
Haslam is acutely aware of the impact digestive disorders can have on patients.
“Most people place a high value on sharing food with family. If food and eating causes pain and other unpleasant experiences, it can be really difficult for that person to adjust,” she explains.
“The effects can be devastating. [Digestive disorders] are not always predictable, and the same disease does not always present the same way in different people.”
Haslam summed up her take on cannabis for digestive disorders as follows: “If cannabis can offer patients relief as part of their personal treatment plan, then I am all for it.”